Changing food, Part 2: Thinking outside the box

by Jeff Gelski
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Infant eating peanut
Could feeding an infant peanuts prevent a peanut allergy?
 

This is the second in a three-part series examining industry efforts to develop safer foods for those with allergies. Read Part 1 here.

KANSAS CITY — This might sound unconventional, but a start-up company and a panel sponsored by the National Institutes of Health both say giving allergen-containing foods to infants potentially may lead to fewer cases of food allergies.

Before Brands, Menlo Park, Calif., is developing edible products that use the company’s Early Adaptive Tolerance blend of whole food proteins and vitamin D to help provide immune system training. The products are designed to be incorporated into the diets of infants about 6 months old.

The products are based on insights and intellectual property developed by Kari Nadeau, M.D., Ph.D., a pediatrician and the director of the Sean N. Parker Center for Allergy and Asthma Research at Stanford University in Stanford, Calif. She co-founded the company in 2015 along with Ashley Dombkowski, Ph.D., chief executive officer.

Before Brands on Oct. 5, 2016, announced it had raised $13.1 million in private funding in a Series A financing round led by Gurnet Point Capital, a health care fund based in Cambridge, Mass.

No peanuts allowed
Food allergies are an accelerating epidemic.

“Food allergies are an accelerating epidemic, now impacting about two kids per classroom in the United States and doubling every 10 years,” Dr. Nadeau, a mother of five children, said. “As a clinician and researcher, I study the interaction between genetics and environmental influences like diet in the context of food allergies and asthma. Before Brands will soon commercialize a line of products based on these insights and designed specifically for healthy infants and toddlers to complement a diverse, fresh and healthy diet while the immune system is developing.”

Introducing infants to peanut-containing foods may prevent the development of peanut allergy, according to a panel sponsored by the National Institute of Allergy and Infectious Diseases, part of the Bethesda, Md.-based National Institutes of Health. The panel this January provided three separate guidelines for infants at various levels of risk for developing peanut allergy.

The first guideline covers infants deemed at high risk of developing peanut allergy because they already have severe eczema, egg allergy or both. The panel recommends peanut-containing foods should be introduced into the infants’ diets as early as 4 to 6 months of age.

The second guideline covers infants with mild or moderate eczema. They should have peanut-containing foods introduced into their diets at about 6 months of age. The third guideline covers infants without eczema or any food allergy. They should have peanut-containing foods freely introduced into their diets.

The guidelines may be found here.

Peanut butter sandwich

The panel was formed after results from a randomized clinical trial to prevent food allergy in a large group of high-risk infants were presented Feb. 23, 2015, at the annual scientific meeting of the American Academy of Allergy, Asthma and Immunology in Houston.

More than 600 children between 4 months and 11 months of age were enrolled in a Learning Early About Peanut allergy (LEAP) study. All the infants were considered a high risk for developing peanut allergy because they had severe eczema and/or egg allergy.

One group of infants ate a peanut-containing snack at least three times a week. The other group did not eat any foods containing peanuts. By the age of 5, 3% of the children who ate the snack developed peanut allergy while 17% in the group that avoided peanuts developed peanut allergy.

The study was published Feb. 26, 2015, in The New England Journal of Medicine and may be found here. In the study, regular peanut consumption achieved an 86% reduction in peanut allergy at age 5 among children who had negative skin prick tests to peanut at study entry and a 70% reduction in peanut allergy among those who were sensitized to peanut (positive skin test) at the beginning of the study.

“For decades allergists have been recommending that young infants avoid consuming allergenic foods such as peanut to prevent food allergies,” said Gideon Lack, M.D., of Kings College London and one of the researchers. “Our findings suggest that this advice was incorrect and may have contributed to the rise in the peanut and other food allergies.”
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